Abstract
The DePEC-Nutrition trial is a complex dietary and behavioural intervention of salt intake reduction combined with increased high-nitrate vegetable consumption among Malaysian middle-aged and older adults with elevated blood pressure. This study aimed to assess the feasibility and acceptability of the trial. Participants were recruited from the South East Asia Community Observatory (SEACO) database and randomised into one of four groups: (1) low salt; (2) high-nitrate vegetable; (3) combined high-nitrate vegetable and low salt; and (4) control. The intervention included a combination of group counselling sessions, information booklets, reinforcement videos and text messages to modify dietary behaviour. The primary outcomes evaluated were the measures of feasibility and acceptability of (1) recruitment, follow-up attendance and retention; (2) data collection procedures and clinical outcome measures; and (3) individual and combined multi-modal dietary interventions. A total of 74 participants were recruited, and the 10-month retention rate was 73%. Data collection procedures were acceptable with minimal missing data. All intervention strategies were feasible and acceptable, with group counselling being the most acceptable strategy. This study provides important insights into improving the screening process of participants, facilitating their access to the research facilities and refining the measurement protocols and dietary recommendations, which are instrumental in formulating the design of a full-scale definitive DePEC-Nutrition trial.
Highlights
Dementia is a neurodegenerative disease characterised by a progressive and significant impairment of cognitive and physical function [1]
The Dementia Prevention and Enhanced Care (DePEC)-Nutrition trial was a randomised, controlled 2 × 2 factorial nutritional intervention conducted between June 2019 and December 2020
We suggest that the definitive DePEC-Nutrition trial should employ a mixed-method approach to deliver the interventions with sessions organised both live and remotely through a telephone or other digital platforms
Summary
Dementia is a neurodegenerative disease characterised by a progressive and significant impairment of cognitive and physical function [1]. The pathogenesis of dementia is complex and linked to the multi-factorial contribution of metabolic and vascular changes, genetics and environmental factors, which occur alongside age-related changes in brain structure and function [2,3]. A certain degree of overlap characterises the risk factor profiles of cardiovascular diseases (CVD) and dementia, and factors such as age, smoking, obesity, physical inactivity and depression are significant contributors to both conditions [5]. High blood pressure is an important modifiable risk factor for both CVD and dementia [6,7,8,9], and evidence from clinical trials has reported significant associations between decreased blood pressure, improved cognition, and reduced CVD [10,11] and dementia risk [12,13,14]. Sodium and inorganic nitrate (via the formation of nitric oxide (NO))
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